Chapter 20 (Excessive bleeding following an extraction) Flashcards Preview

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excessive bleeding

- complications can occur from extraction
- At risk patients:
1. hemophiliac
2. patients taking anticoagulants
3. patients experiencing a hematoma


what is hemophilia?

- group of hereditary disorders with deficiency of clotting factor
- can be mild to severe


what are the special care for extraction on people with excessive bleeding?

- recombinant factor injections or IV prior to surgery
- use of glue, gelatin packing, and absorbable sutures
- vasoconstrictors in the LA
- compression for 3 days following surgery


what are some anticoagulants for excessive bleeding?

- aspirin
- warfarin
- heparin



- 3 types; low, moderate, and high risk
low- no medication change
moderate- withdrawal 48 hours prior to extraction
high- consultation with physician- needs to determine risk of bleeding verses clotting
- INR- international normalized ratio
a. determines clotting time
b. used during warfarin therapy
c. 2.0-3.0 target range



- used for thrombogenic episodes in hospitalized patients undergoing complicated surgery
- reduces blood clotting immediately
- short acting
- no need to discontinue for simple procedures, e.i extraction



- used to treat ischemic heart disease, TIA, CVA
- minor oral surgery on patients with low dose aspirin regimen
- used for follow-up procedures yields minimal post extraction bleeding



- collection of blood trapped beneath skin
- caused by truma including LA injection
- careful and knowledgeable injection is best prevention


what if hematoma occurs?

- apply firm pressure with gauze until no longer expanding, place cold pack, and possibly use antibiotics
- if expansion continues- EMS


signs and symptoms of excessive bleeding

- easily recognized
- heavy bleeding unaffected by compression lasting up to 2 hours
- also look for fever, hypertension, altered mental capacity, and hematoma


treatment and prevention of excessive bleeding (POST SURGERY)

- no exercise 12-24 hours
- lie down with head elevated for several hours
- place gauze over socket and apply pressure for 2 hours